Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 17-01011 | KS |
N | 225XH1200X | Occupational Therapist - Hand | 2005035147 | MO |
NPI | 1033436035 |
---|---|
Provider Name | Ms. Susan E Heimke |
First Address | Overland Park, KS 66202 |
Second Address | Overland Park, KS 66202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 29/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17-01011 | KANSAS STATE BOARD OF HEALING ARTS (01) | KS |